Growth Hormone Therapy a Potential Risk to Older Adults
Jan 15, 2020 Cedars-Sinai Staff
The off-label use of recombinant human growth hormone (GH) continues to rise in the U.S. and worldwide, reports Endocrine Today. Among some endocrinologists, there are concerns that GH therapy is being prescribed to older adults, potentially ignoring the serious risks associated with this so-called "anti-aging wonder drug."
Shlomo Melmed, MB, ChB, executive vice president of Academic Affairs, dean of the medical faculty and professor of Medicine at Cedars-Sinai, cautioned against GH therapy in individuals who are not growth hormone-deficient.
"Growth hormone definitely is lipolytic and causes fat weight loss, and so that is very enticing to an internist managing a 70-year-old individual who has the resources to pay for growth hormone," Melmed said in an interview with Endocrine Today.
"There is a robust body of pre-clinical evidence now that low growth hormone is in fact beneficial for many diseases of aging, especially cancer."
In healthy individuals, studies have shown that lower levels of GH are related to longevity and a lower risk of cancer as people reach old age.
"These clinicians [administering GH] may in fact be negating any potential benefits of the physiologic drop of growth hormone level that occurs during aging," Melmed said.
The growing evidence of low-growth hormone benefits
A January 2019 review published in the World Journal of Men's Health analyzed studies in which mouse models have demonstrated an absence of GH signals. The lack of these GH signals—due to mutations affecting anterior pituitary development, GH secretion or GH receptors—suggests that aging is slowed or delayed in the absence of GH.
"There is a robust body of pre-clinical evidence now that low growth hormone is in fact beneficial for many diseases of aging, especially cancer," Melmed said.
Melmed made it clear there is no prospective study showing that the frailty of aging is reversed or slowed by GH, nor is there any data that growth hormone boosts longevity in healthy individuals in any way.
Testing for GH deficiency
Many clinicians wonder if older adults with a low IGF-1 level should be tested for GH deficiency. Melmed told Endocrine Today that in most cases, they should not.
He added that the general use of GH therapy by internists should be discouraged.
"If a patient is suspected of growth hormone deficiency, they should be seen by a qualified endocrinologist who understands the pitfalls and caveats of growth hormone reserve testing in the adult," Melmed advised.